Objective To evaluate the clinical effect of acupuncture in the treatment of depression after stroke. Methods 90 patients with cerebral apoplexy were randomly divided into 2 groups according to the random number table, with 45 cases in each group. Patients in both groups were given routine western medicine treatment, and guided to carry out suitable limb function rehabilitation training. In addition, the control group was given traditional acupuncture treatment, while the treatment group was given the brain acupuncture treatment with tiaodu in addition to the traditional acupuncture treatment. Hamilton depression scale (HAMD) was used to assess the degree of depression, Chinese stroke scale (CSS) was used to evaluate the degree of neurological deficit, and barthel index (BI) was used to evaluate the activity of daily living (ADL). Results After treatment, the treatment group has a lower CSS score than that of the control group (11.38 ± 3.94 vs. 15.16 ± 4.52, t=4.229), and a lower HAMD score than that of the control group (6.25 ± 3.76 vs. 9.32 ± 5.06, t=3.267). Meanwhile, the treatment group has a higher BI score than that of the control group (69.22 ± 7.05 vs. 55.67 ± 6.21; t=9.675, P<0.01). Furthermore, the treatment group has statistically significant higher cure rate than that of the control group (62.2% vs. 33.3%;χ2=6.413, P=0.011). Conclusions Tiaodu brain acupuncture treatment of depression after stroke has obvious clinical curative effect, and is superior to other traditional acupuncture method.

Adenocarcinoma, Papillary ; blood supply ; metabolism ; pathology ; Adult ; Aged ; Carcinoma, Pancreatic Ductal ; blood supply ; metabolism ; pathology ; Chemokine CXCL12 ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymph Nodes ; metabolism ; Lymphatic Metastasis ; Male ; Microvessels ; pathology ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; metabolism ; pathology ; Pancreas ; metabolism ; Pancreatic Neoplasms ; blood supply ; metabolism ; pathology ; Receptors, CXCR4 ; metabolism

OBJECTIVE To comprehend the main pathogens and their drug resistance of multiple organ dysfunction syndrome(MODS) patients in ICU.METHODS We retrospectively analyzed all the bacteria isolated from 40 MODS patients in ICU.RESULTS The number of bacteria strains isolated was 173,92 G-bacteria strains made up 53.18%,60 G+ bacteria strains made up 34.68%,and 21 fungi strains made up 12.14%.The top six were Staphylococcus aureus(23.70%,MRSA was 13.87%),Pseudomonas aeruginosa(14.45%),Acinetobacter baumannii(11.56%),Stenotrophomonas maltophilia(8.67%),Candida tropicalis(8.09%),and Enterococcus faecalis(7.51%).The susceptive rate of S.aureus and Enterococcus to vancomycin was all 100%,the susceptive rate of A.baumannii and Klebsiella pneumoniae to carbapenems was high.64% patients had the multiplicity of infection(MOI) which always linked with long period in ICU,respiratory failure and mechanical ventilation.CONCLUSIONS MODS patients have a high morbility of G+ bacteria,fungi and MOI,most pathogens show multi-resistance to commonly used antibiotics.Strengthening the monitoring of infection and reasonable using antibiotics should be taken.

In spite of the relative success achieved in degree-oriented education program in clinical medicine during its preliminary trial stage, problems remain in regard to its recognition and understanding, administration policy, testing systems and the quality control. To further improve the Effects of the actual teaching, it is of high importance that we further our understanding, strengthen the administration, consolidate the testing system and implement better supervision of the teaching procedures of the program.

Objective To execute medical insurance little catalogue warning in HIS to prevent the doctor from providing medical service beyond medical insurance coverage.Methods Medical insurance little catalogue was established to regulate the boundaries for medical services available for different patients,and corresponding software was embedded into the medical workstation to call medical insurance little catalogue so as to realize warning for the boundaries and reimbursement rate.Results The function decreased the doctor's workload and the patient's cost while enhanced the doctor's efficiency and the doctor-patient relationship.Conclusion The function is easy to realize with high feasibility,and thus is worthy promoting practically.

Objective To evaluate the efficacy and safety in the treatment of acetabular fractures via anterior approaches,including ilioinguinal,stoppa,pararectus approach.Methods Systematic literature retrieval was carried out to obtain two-arm and one-arm researches on the treatment of acetabular fractures via any one of the three approaches before May 2017,from pubmed,embase,cochrane library Databases.Data extraction and quality evaluation of studies were performed by 3 investigators independently.A meta-analysis was performed by RevMan 5.3 and Meta-Analyst beta 3.13.Results Totally 22 low to moderate quality studies,including 7 two-arm and 15 one-arm were included.There were 980 patients,including 581 in ilioinguinal approach group,264 in stoppa approach group and 135 in pararectus approach group.Meta-analysis showed the rate of anatomic reduction in stoppa approach was higher than that in ilioinguinal approach (OR=0.58,95％CI:0.36-0.94,P=0.03),which in pararectus approach was higher than that in ilioinguinal approach (0R=2.95,95％CI:1.22-7.10,P=0.02).Compared to the ilioinguinal approach,the operation time in the Stoppa approach was shorter (MD=48.01,95％CI:17.08-78.95,P=0.002),there was no statistically significant difference between pararectus approach and ilioinguinal approach.In addition,there were no statistically significant differences among three approaches in intra-operative blood loss,postoperative functional outcomes and complications.Conclusion The available limited evidence suggests that the rate of anatomical reduction in stoppa and pararectus approach may be higher than ilioinguinal approach.Compared to the ilioinguinal approach,the operation time in the stoppa approach may be shorter.In this field,further rigorous design,baseline parallel,direct comparison controlled studies on this topic are still needed.

Objective To understand the status of resistance to multiple insecticides and the frequencies of kdr mutations in Culex pipiens pallens from north?central Anhui Province. Methods From July to September,2014,the C. pipiens pallens mosquito larvae were collected in Huaibei,Bengbu and Chuzhou cities of the north?central Anhui Province and reared to adults. The female adult mosquitoes at 3-5 days post emergence were tested for susceptibility to the four insecticides,namely 0.05%deltamethrin,5%malathion,0.1%bendiocarb and 4%DDT,by using the standard WHO resistance tube bioassay. The detec?tion of the point mutations of the kdr gene at codon 1014 was conducted by PCR and DNA sequencing in the deltamethrin?resis?tant and?susceptible mosquitoes. Results High levels of resistance to all the four insecticides were found in all the three tested populations,although mosquito mortality varied among populations and test insecticides. Among the test insecticides,DDT showed lowest mortality with no significant difference(F=1.027,P>0.05)in all test populations,whereas significantly differ?ent mortalities were observed among populations for the remained three insecticides tested(deltamethrin,malathion,and ben?diocarb)(F = 23.823,33.955,128.841;all P < 0.01). Two types of non?synonymous kdr mutation at codon position 1014 (L1014F and L1014S)were observed. A positive correlation between L1014F mutation frequencies and deltamethrin resistance levels were detected in the three mosquito populations(r2=0.718,P<0.01). Conclusions The observed high levels of resis?tance to multiple?insecticides coupled with the occurrence of medium to high kdr frequencies in populations of C. pipiens pallens could profoundly affect the mosquito vector control programme in China. The local health departments need to strengthen vector dynamic monitoring and implement rational resistance management strategies.

Objective To explore the outcome of monoclonal gammopathy of undetermined significance (MGUS). Methods The data from 14 MGUS patients in our hospital including clinical features, outcome and change of M protein concentration were analyzed retrospectively. Results The MGUS didn't have the clinical manifestations of multiple myeloma (MM), the time of outcome from MGUS to MM was about 4-20 years (mean time, 10 years). The most types of MM were IgA and IgG, 6 cases were IgA type, 6 cases were IgG type and 2 cases were light chain type. The concentration of immune globulin in general showed an upward trend year by year. A few showed fold lines ascend. Conclusions The elevated monoclonal immunoglobulin may develop into MM after many years. We must follow up frequently to avoid error diagnosis and missed diagnosis.

Adolescent ; Cord Blood Stem Cell Transplantation ; adverse effects ; Humans ; Hypertensive Encephalopathy ; etiology ; Male ; Transplantation, Homologous

Background Oxygen-induced retinal neovascularization is the main pathological basis for many retinal vascular diseases.Research showed that light exposure at night can suppress retinal neovascularization in oxygen-induced retinopathy(OIR),but there were few reports discussing its effect on ROP.Objective This study aimed to observe the effect of light exposure at night on retinal neovascularization in an OIR mouse model.Methods Sixty-four newborn C57 BL/6J mice were randomly divided into four groups,with 16 mice for each group.OIR models were established by rearing the newborn C57BL/6J mice with their mothers in a(75±2)％ oxygen environment from postnatal day 7(P7)to Pl2,and then transferred to room air.In the OIR model group,the environmental illumination level was the same as the normal control group,and the model mice were exposed to 100 lx light at night in the OIR+ light exposure group.In the simple light exposure group,normal mice were reared in room air and were exposed to light at night from P12 to P17.All the mice were sacrificed on P17,and retinal flat mounts were prepared to assess the oxygen-induced changes of retinal vessels using the adenosine diphosphatase(ADPase)histochemical technique.The amount of proliferative neovascularization was quantified by counting the number of endotheliocyte nuclei in new vessels extending from the retinal inner limiting membrane into the vitreous in ocular cross-sections.The expression of the vascular endothelial growth factor(VEGF)protein was detected by immunohistochemistry.Real-time PCR analysis was performed to examine the expression of VEGF mRNA.The rearing and usage of the animals complied with the Statement of ARVO.Results Less free-vascular areas and new blood vessels were seen in the OIR+light exposure group compared with the OIR model group.On day 17 of the mouse life,the number of the endotheliocyte nuclei in new vessels extending from retinal inner limiting membrane were 0.97±0.83,1.00±0.72,38.57±5.01 and 16.92±3.39 in the normal group,simple light exposure group,OIR model group and OIR+light exposure group,respectively,showing significant differences among them(F =78.767,P =0.000).The number of nuclei in the OIR+light exposure group were less than that of the OIR model group(t=20.446,P＜0.01).Immunochemistry showed that the expression of VEGF in retina was weaker in the OIR+light exposure group than the OIR model group.The relative expression values of VEGF mRNA were 1.00±0.00,0.94±0.07,2.08±0.50 and 1.43±0.21 in the normal group,simple light exposure group,OIR model group and OIR+light exposure group,respectively,showing a significant difference (F=11.268,P =0.003),where the VEGF mRNA level in the OIR+light exposure group was lower than that of the OIR model group(t =20.163,P＜0.05).Conclusions Light exposure at night can weaken retinal neovascularization in OIR mice